Teaching and mentoring

Mentorship for new pharmacists to help develop their generalist skills

• NHS England introduced a Structured Medication Review (SMR) service within Primary Care Networks (PCNs), to address problematic polypharmacy, reduce avoidable hospitalisations and deliver better value from medicines spending. New pharmacists who lacked patient-facing expertise were found to draw on pre-existing frameworks and templates, lacking the skills and experience to deliver holistic reviews, meaning opportunities for shared-decision making were potentially missed.

Suggested WiseGP actions:

1. New pharmacists require support to develop their skills working beyond guidelines and to share decision making with patients before they can deliver effective SMRs. Could they be supported and mentored by pharmacists with more general practice experience within your PCN, or could complex reviews be discussed with a GP mentor initially to facilitate the development of these skills in pharmacists who are new to practice?

Read more about this research here:

https://bjgp.org/content/72/722/e641

Approaches to help prevent GP burnout

• Moderate to high GP burnout exists worldwide. To help address this, clinicians need some autonomy over their work, a sense of belonging within their team and to feel they are delivering valued outcomes. There is an overarching need for investment in the workforce to deliver greater numbers of doctors.

Suggested WiseGP actions:

1. Have a look at our first WiseGP newsletter produced in response to GP burnout- can you identify any changes you could make to help protect yourself and your colleagues? (link)

Examples include promoting patient self-care, reducing sessions or developing a portfolio career, getting appropriate locum cover when indicated, task delegation, innovative use of new PCN team members, helping the duty doctor when they’re struggling and being assertive when declining inappropriate work from secondary care.

Read more about the research informing these recommendations here: https://bjgp.org/content/72/718/e316

bjgp.org

Recent weeks have seen GPs giving evidence to a parliamentary committee on the crisis facing UK general practice, with particular focus being placed on the need to recruit and retain the workforce. GPs were dissatisfied and struggling before the COVID-19 pandemic,1–3 but, as a systematic review included in this issue suggests,4 this period has exposed GPs to additional pressures without the resources to manage them. Several commentaries have been made as to the sources of these pressures and there has been a call to action for policymakers to address growing issues of general practice capacity. UK GP workforce vacancy rates reveal one in seven GP posts are currently vacant,5 but while increasing the pool of doctors will take some time to achieve, here we consider potential solutions to support general practice in the immediate term and retain those doctors we have. In the spirit of CS Lewis: ‘You can’t go back and change the beginning, but you can start where you are and change the ending’ . We use Michael West’s framework — the ABC of needs6,7 — to frame policy solutions for general practice using the concepts of autonomy, belonging, and contribution that have previously been shown to be integral to promoting the wellbeing of the health workforce. Our own research evidence4,8,9 highlights how these key characteristics were eroded during the COVID-19 pandemic, but understanding the importance of these facets may also offer future solutions. GPs’ autonomy and …